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November 18, 2008  
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PIIPA Resource Center
   Perguntas Mais Frequentes
Acronym/Term Glossary
   Pesquisa sobre Países e Regiões
Library
IP Resource Sites
Sectors
Agriculture
Biodiversity
Traditional Knowledge
Health Care
Environment
Information Technology
Science and Technology

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PIIPA - Client Registration
Application for Assistance
A principal goal of PIIPA is to improve the ability of developing countries to manage, protect, or challenge IP in the public interest. To this end, PIIPA was formed to help governments, government agencies and non-government public service organizations acquire IP expertise on a pro bono basis, in order to meet the health, agricultural, environmental and cultural needs of poor and underprivileged people in developing countries and worldwide.

We typically will not consider requests from organizations whose primary purpose is political or religious. However, if those organizations have a specific non-political or secular activity that directly benefits the advancement of a less developed country or its people, we will consider the request.

If you wish to seek assistance, please complete the application form on-line or print and mail to:
PIIPA
1200 Pennsylvania Avenue N.W.
PO Box 548
Washington, DC 20044-0548 USA
Consent and Acknowledgement
I have read and agree to the Applicant Consent Form.
Click here if you agree (required)

Primary Contact Information
Primary Contact First Name
Primary Contact Middle Name
Primary Contact Last Name
Username (must be at least 5 characters)  (required)
Password (must be at least 5 characters)  (required)
Confirm Password  (required)
Email  (required)
Telephone
Fax


Organization Information
Organization's Name
Street
City
State
Province
ZIP Code
Country

Type of Organization (Check all that apply.)
Non-Profit Government Agency
Underfinanced Organization Educational Institution
Small Enterprise  

Type of Project (Check all that apply.)
Agriculture Biodiversity
Environment Folklore/Traditional Knowledge
Health Information Technology
Scientific Research Other 

Expected Intellectual Property Issues, if known (Check all that apply.)
Licensing Trademark
Counseling Patent
Prosecution Trade Secrets
Litigation Copyright
Other   

Countries Involved
Please list all countries that might be involved.

Languages Skills Required
List all languages applicable to the requested assistance, including English, if applicable.
Speak
Read
Write

Description of the Requested Assistance and It's Public Interest Importance
Do not include confidential, sensitive, or privileged information at this time. Only put information you would be comfortable having PIIPA forward to others if we accept your application. If describing your price requires discussion of confidential information, please note that here for follow up.


Where did you hear about PIIPA?
Describe which websites, colleagues, or publications.

 

Questions about this form?
Send an email to the webmaster.